EMS Billing Service

Type: Tender
ID: 1006499
Category: Medical Billing Services
Title: EMS Billing Service
Clients Approx Budget: Need Best Proposals
Volume of Work: 3 Years Contract
Description: We are US based looking to outsource our requirement of Medical Billing Service. We are looking for EMS Billing Services. The duration of the contract is 3 years.

Scope:
1. Be able to set up financial categories (e.g. Medicare, Medi-Cal, HMO’s, Private Pay, Insurance, etc) as required by us for a minimum of 6 individual entities (ambulance response areas).
2. Have the ability to receive, ambulance transport documentation on paper and electronically.
3. Obtain patients’ or guardian’s signature and authorizations as required.
4. Research accounts with inadequate billing information.
5. Be able to interpret documents for accurate billing to responsible party or insurance company.
6. Send insurance claims to payers either electronically or via mail (to those who accept hard copy submissions only). Claims must be submitted to the correct address for claim submission.
7. Mail initial invoices to self-pay accounts with no 3rd party information, requesting 3rd party information, or payment in full.
8. Verify eligibility for 3rd party payer prior to claim submission (e.g. Workers’ Compensation, etc).
9 Appeal all inaccurately, denied or down-coded claims from Medicare, Medi-Cal, Workers’ Compensation and insurance carriers. Request Appeal Hearing or Lien Conference.
10 Produce and mail notices and make calls on all open accounts, to collect amounts due to us.
11. Send “cross-over” and balance billings to responsible parties as necessary.
12. Process payments, adjustments, receipts and correspondence.
13. Forward accumulated revenue to us on a weekly basis.
14. Forward refund requests and associated back-up documentation, to us for processing.
15. Review all accounts deemed delinquent before transferring to us for further action.
16. Provide nationwide toll-free telephone line(s) to accommodate billing inquires from patients and other responsible parties. Provide a multi-lingual staff for communication.
17. Provide revenue, accounting or other requested reports on a monthly, quarterly and annually.
18. Have the ability to track subscriber memberships and bill and/or write-off accounts according to our policy and produce reports detailing these accounts.
19. Provide electronic access to all records/reports to our authorized staff.
20. Comply with Workers’ Compensation Rules and regulations as lien holder.
21. Comply with all County, State and Federal (including HIPPA and Identity Theft) laws, policies, standards, and guidelines regarding the release of any data pertaining to patients or us.
22. Coordinate with the existing service provider to transition current accounts with minimal disruption to service.

This is an on shore and off site tender. Interested service providers are requested to contact no later than April, 30, 2010, 5:00 PM by courier, post or email. Service providers may have to visit our premises for meeting or Briefings.

Country: United States


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